Association of physical fitness with health-related quality of life in Finnish young men

Abstract Background Currently, there is insufficient evidence available regarding the relationship between level of physical fitness and health-related quality of life (HRQoL) in younger adults. Therefore, the aim of the present study was to investigate the impact of measured cardiovascular and musculoskeletal physical fitness level on HRQoL in Finnish young men. Methods In a cross-sectional study, we collected data regarding the physical fitness index, including aerobic endurance and muscle fitness, leisure-time physical activity (LTPA), body composition, health, and HRQoL (RAND 36) for 727 men [mean (SD) age 25 (5) years]. Associations between HRQoL and the explanatory parameters were analyzed using the logistic regression analysis model. Results Of the 727 participants who took part in the study, 45% were in the poor category of the physical fitness, while 37% and 18% were in the satisfactory and good fitness categories, respectively. A higher frequency of LTPA was associated with higher fitness (p < 0.001). Better HRQoL in terms of general health, physical functioning, mental health, and vitality were associated with better physical fitness. When the HRQoL of the study participants were compared with that of the age- and gender-weighted Finnish general population, both the good and satisfactory fitness groups had higher HRQoL in all areas other than bodily pain. In a regression analysis, higher LTPA was associated with three dimensions of HRQoL, higher physical fitness with two, and lower number of morbidities with all dimensions, while the effect of age was contradictory. Conclusions Our study of Finnish young men indicates that higher physical fitness and leisure-time physical activity level promotes certain dimensions of HRQoL, while morbidities impair them all. The results highlight the importance of health related physical fitness while promoting HRQoL.peerReviewe

Improvements of muscle strength predicted benefits in HRQOL and postural balance in women with fibromyalgia: an 8-month randomized controlled trial

OBJECTIVE: To evaluate whether changes in muscle strength due to 32 weeks of supervised aquatic training predicted improvements on health-related quality of life (HRQOL). METHODS: Thirty women with FM aged 50.8 +/- 8.7 years were randomly assigned to an experimental group (n = 15), performing 3 weekly sessions of 60 min of warm-water exercise; or to a control group (n = 15). HRQOL was evaluated using the Short Form 36 Health Survey (SF-36). Maximal unilateral isokinetic strength was measured at 60 degrees/s and 210 degrees/s in the knee extensors and flexors in concentric action and at 60 degrees/s in knee extensors eccentric action. Postural balance was evaluated using the one-leg stance, eyes closed. RESULTS: After 32 weeks of water exercise therapy, statistically significant improvements occurred in concentric knee flexors and extensors strength at 60 degrees/s, in eccentric knee extensors and in postural balance. The treatment led to additional improvements in physical function, role physical problems, body pain, general health, vitality, role emotional problems and mental health dimensions of SF-36. Gains in the concentric knee flexors strength predicted improvements in role of physical problems, whereas those in concentric knee extensors did the same for mental health and role emotional problems. Gains in eccentric knee extensors strength predicted improvements in postural balance. CONCLUSIONS: A long-lasting exercise therapy in warm water produced relevant gains in muscle strength at low velocities of movements, some of which predicted improvements in physical problems, emotional problems, mental health and balance. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number ISRCTN53367487, information available in http://www.controlled-trials.com/ISRCTN53367487

Eight-month of physical training in warm water improves physical and mental health in women with fibromyalgia: a randomized controlled trial

OBJECTIVE: To evaluate the feasibility of 8 months of supervised exercise therapy in warm water and its effects on the impact of fibromyalgia on physical and mental health and physical fitness in affected women. METHODS: Thirty women with fibromyalgia were randomly assigned to an exercise therapy group (n = 15) or a control group (inactive) (n = 15). The impact of fibromyalgia on physical and mental health was assessed using the Fibromyalgia Impact Questionnaire and the anxiety state with State-Trait Anxiety Inventory. Physical fitness was measured using the following tests: Canadian Aerobic Fitness; hand-grip dynamometry; 10-metre walking; 10-step stair-climbing and blind 1-leg stance. RESULTS: After 8 months of training, the exercise therapy group improved compared with the control group in terms of physical function (20%), pain (8%), stiffness (53%), anxiety (41%), depression (27%), Fibromyalgia Impact Questionnaire total scores (18%), State-Trait Anxiety Inventory score (22%), aerobic capacity (22%), balance (30%), functional capacity for walking (6%), stair-climbing with no extra weight (14%) and stair-climbing 10 kg-weighted (25%). CONCLUSION: Eight months of supervised exercise in warm water was feasible and led to long-term improvements in physical and mental health in patients with fibromyalgia at a similar magnitude to those of shorter therapy programmes

Aquatic training and detraining on fitness and quality of life in fibromyalgia

PURPOSE: To evaluate the effects of a 12-wk period of aquatic training and subsequent detraining on health-related quality of life (HRQOL) and physical fitness in females with fibromyalgia. METHODS: Thirty-four females with fibromyalgia were randomly assigned into two groups: an exercise group, who exercised for 60 min in warm water, three times a week (N = 17); and a control group, who continued their habitual leisure-time activities (N = 17). HRQOL was assessed using the Short Form 36 questionnaire and the Fibromyalgia Impact Questionnaire. Physical fitness was measured using the following tests: Canadian Aerobic Fitness, hand grip dynamometry, 10-m walking, 10-step stair climbing, and blind one-leg stance. Outcomes were measured at baseline, after treatment, and after 3 months of detraining. RESULTS: After 12 wk of aquatic exercise, significant positive effects of aquatic training were found in physical function, body pain, general health perception, vitality, social function, role emotional problems and mental health, balance, and stair climbing. After the detraining period, only the improvements in body pain and role emotional problems were maintained. CONCLUSION: The present water exercise protocol improved some components of HRQOL, balance, and stair climbing in females with fibromyalgia, but regular exercise and higher intensities may be required to preserve most of these gains

Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients

Purpose: Interleukin 6 (IL-6) and the acute phase C-reactive protein (CRP) blood concentrations after lumbar spine fusion may be affected by age. The purpose of this prospective observational study was to assess postoperative serum levels of pro-inflammatory IL-6 and CRP after instrumented lumbar spine fusion surgery. We hypothesized that older patients would have increased levels of IL-6 and CRP after surgery. Methods: IL-6 and high-sensitive CRP biochemical marker levels were measured before instrumented spinal fusion, and postoperatively at 1 and 3 days, 6 weeks, and 3 months. The 49 patients in this sample were divided into two groups: age 60 years (n = 26). Results: Acute changes in IL-6 high-sensitivity and CRP from preoperative levels to postoperative day (POD) 1 increased with age. Mean (95% CI) difference between the age-groups in changes of IL-6 at PODs 1 and 3 was 45 pg/ml (10-83, p = 0.014) and 20 pg/ml (5-36, p = 0.021), respectively. Mean (95% CI) difference between groups in changes of CRP at PODs 1 and 3 was 9.6 mg/l (-3.5 to 22.7, p = 0.47) and 24.8 mg/l (-17 to 67, p = 0.33), respectively. Both groups had decreased IL-6 and CRP levels at 6 weeks after surgery compared to the preoperative level. Conclusions: Elevation of IL-6 and CRP is stronger in patients over 60 years old after instrumented lumbar spinal fusion. The CRP and IL-6 are sensitive markers for acute postoperative inflammation. Even high acute CRP values do not necessarily indicate postoperative infection.Peer reviewe

Greater strength gains after training with accentuated eccentric than traditional isoinertial loads in already strength-trained men

As training experience increases it becomes more challenging to induce further neuromuscular adaptation. Consequently, strength trainers seek alternative training methods in order to further increase strength and muscle mass. One method is to utilize accentuated eccentric loading, which applies a greater external load during the eccentric phase of the lift as compared to the concentric phase. Based upon this practice, the purpose of this study was to determine the effects of 10 weeks of accentuated eccentric loading vs. traditional isoinertial resistance training in strength-trained men. Young (22 ± 3 years, 177 ± 6 cm, 76 ± 10 kg, n = 28) strength-trained men (2.6 ± 2.2 years experience) were allocated to concentric-eccentric resistance training in the form of accentuated eccentric load (eccentric load = concentric load + 40%) or traditional resistance training, while the control group continued their normal unsupervised training program. Both intervention groups performed three sets of 6-RM (session 1) and three sets of 10-RM (session 2) bilateral leg press and unilateral knee extension exercises per week. Maximum force production was measured by unilateral isometric (110° knee angle) and isokinetic (concentric and eccentric 30°.s-1) knee extension tests, and work capacity was measured by a knee extension repetition-to-failure test. Muscle mass was assessed using panoramic ultrasonography and dual-energy x-ray absorptiometry. Surface electromyogram amplitude normalized to maximum M-wave and the twitch interpolation technique were used to examine maximal muscle activation. After training, maximum isometric torque increased significantly more in the accentuated eccentric load group than control (18 ± 10 vs. 1 ± 5%, p \u3c 0.01), which was accompanied by an increase in voluntary activation (3.5 ± 5%, p \u3c 0.05). Isokinetic eccentric torque increased significantly after accentuated eccentric load training only (10 ± 9%, p \u3c 0.05), whereas concentric torque increased equally in both the accentuated eccentric load (10 ± 9%, p \u3c 0.01) and traditional (9 ± 6%, p \u3c 0.01) resistance training groups; however, the increase in the accentuated eccentric load group was significantly greater (p \u3c 0.05) than control (1 ± 7%). Knee extension repetition-to-failure improved in the accentuated eccentric load group only (28%, p \u3c 0.05). Similar increases in muscle mass occurred in both intervention groups. In summary, accentuated eccentric load training led to greater increases in maximum force production, work capacity and muscle activation, but not muscle hypertrophy, in strength-trained individuals

Stress hormone response to instrumented elective lumbar spine fusion surgery

Purpose: To understand the systemic effect of major spine surgery, we investigated stress, anabolic and catabolic hormonal levels and their association with interleukin 6 (IL-6) in patients undergoing elective lumbar spine fusion surgery. Methods: Blood samples were collected preoperatively, and at 1, 3, 42, 90 days postoperatively (POD) from 49 patients who underwent elective lumbar spine fusion surgery. Results: Serum concentration of cortisol was below the preoperative value at POD 1 but did not differ from the baseline values thereafter. Adrenocorticotropic hormone (ACTH) decreased at PODs 1 and 3. Testosterone decreased at PODs 1 and 3 in men, and at POD 3 in women. Sex hormone-binding globulin decreased at PODs 1 and 3 in both genders. No changes were observed in free testosterone or growth hormone concentrations. Insulin-like growth factor 1 increased significantly above the preoperative level at PODs 42 and 90 in women, and at POD 42 in men. IL-6 was significantly elevated at PODs 1 and 3. Increases in IL-6 from the preoperative level to POD 1 correlated significantly with decreases of cortisol at POD 1 but not with ACTH. Conclusions: There were only short-term stress hormonal changes after elective lumbar spine fusion surgery. Cortisol changes after elective lumbar spine surgery are transient and might be partly cytokine induced and non-ACTH driven since there was association between cortisol and IL-6 but not with ACTH and IL-6.Peer reviewe

Cortisol is related to acute leukocytosis in maximal but not in hypertrophic dynamic resistance exercise

Introduction. Exercise induces immune changes that are multifactorial and include neuroendocrine factors. Acute resistance exercise is followed by marked increases in adrenaline, cortisol, growth hormone, and other factors that have immunomodulatory effects. The purpose of the present study was to investigate the relationship between leukocytosis and hormone responses to two different resistance exercises, low volume high load (gains in maximal strength, MAX) and high volume medium load (gains in muscle mass, HYP). Methods. Using a cross-over design twelve healthy men participated in bilateral leg press exercise consisting of 5 sets of 10 RM and 15 sets of 1 RM. The inter-set rest period was 3 minutes for MAX and 2 minutes for HYP. Venous blood samples were taken at baseline, immediately after (P0) and 15 (P15) and 30 (P30) minutes after the exercise. Basic blood count was analyzed using Sysmex KX-21N (TOA Medical Electronics Co., Ltd., Kobe, Japan). Serum cortisol (COR), testosterone (TES), and growth hormone (GH) concentrations were analyzed by an immunometric chemiluminence method (Immunlite R 1000, DPC, Los Angeles, USA) Results. Both exercises induced significant acute leukocytosis (p\u3c0.001). Leukocytosis was significantly higher after HYP (p\u3c0.01). COR and TES increased significantly after HYP (p\u3c0.01) but not in MAX. GH increased significantly (p\u3c0.05) in both exercises and stayed elevated at P30 in HYP. There was a significant negative correlation between acute leukocytosis and cortisol at P0 in MAX (R=-0.622, p=0.031) but not in HYP r=0.287 (p=0.366). Significant correlations between TES, GH and leukocytes were not observed. Conclusions. Clearly, manipulation of the rest period and load in resistance exercise alters endocrinal as well as immunological responses. Hypertrophic resistance exercise triggered significantly stronger immunological as well as endocrinal responses. In line with the previous studies (e.g. Kraemer et al. 1996) cortisol did not correlate with leukocytes nor with leukocyte subgroups in HYP. It might be that cortisol acts as an anti-inflammatory agent in MAX, however in HYP leukocytosis appears to be related to additional physiological mechanisms e.g. muscle damage and metabolic demands, which might explain why we did not observe the same in HYP. When considering recovery from resistance exercise the immune system should be monitored in addition to hormones

Effects of upper body eccentric versus concentric strength training and detraining on maximal force, muscle activation, hypertrophy and serum hormones in women

Effects of eccentric (ECC) versus concentric (CON) strength training of the upper body performed twice a week for 10 weeks followed by detraining for five weeks on maximal force, muscle activation, muscle mass and serum hormone concentrations were investigated in young women (n = 11 and n = 12). One-repetition bench press (1RM), maximal isometric force and surface electromyography (EMG) of triceps brachii (TB), anterior deltoid (AD) and pectoralis major (PM), cross-sectional area (CSA) of TB (Long (LoH) and Lateral Head (LaH)) and thickness of PM, as well as serum concentrations of free testosterone, cortisol, follicle-stimulating hormone, estradiol and sex hormone-binding globulin were measured. ECC and CON training led to increases of 17.2 ± 11.3% (p \u3c 0.001) and 13.1 ± 5.7% (p \u3c 0.001) in 1RM followed by decreases of-6.6 ± 3.6% (p \u3c 0.01) and-8.0 ± 4.5% (p \u3c 0.001) during detraining, respectively. Isometric force increased in ECC by 11.4 ± 9.6 % (p \u3c 0.05) from week 5 to 10, while the change in CON by 3.9±6.8% was not significant and a between group difference was noted (p \u3c 0.05). Maximal total integrated EMG of trained muscles increased only in the whole subject group (p \u3c 0.05). CSA of TB (LoH) increased in ECC by 8.7 ± 8.0% (p \u3c 0.001) and in CON by 3.4 ± 1.6% (p \u3c 0.01) and differed between groups (p \u3c 0.05), and CSA of TB (LaH) in ECC by 15.7 ± 8.0% (p \u3c 0.001) and CON by 9.7 ± 6.6% (p \u3c 0.001). PM thickness increased in ECC by 17.7 ± 10.9% (p \u3c 0.001) and CON by 14.0 ± 5.9% (p \u3c 0.001). Total muscle sum value (LoH + LaH + PM) increased in ECC by 12.4 ± 6.9% (p \u3c 0.001) and in CON by 7.1 ± 2.9% (p \u3c 0.001) differing between groups (p \u3c 0.05) and decreased during detraining in ECC by-6.5 ± 4.3% (p \u3c 0.001) and CON by-6.1 ± 2.8% (p \u3c 0.001). The post detraining combined sum value of CSA and thickness was in ECC higher (p \u3c 0.05) than at pre training. No changes were detected in serum hormone concentrations, but baseline free testosterone levels in the ECC and CON group combined correlated with changes in 1RM (r = 0.520, p \u3c 0.016) during training. Large neuromuscular adaptations of the upper body occurred in women during ECC, and CON training in 10 weeks. Isometric force increased only in response to ECC, and total muscle sum value increased more during ECC than CON training. However, no changes occurred in serum hormones, but individual serum-free testosterone baseline concentrations correlated with changes in 1RM during strength training in the entire group. Both groups showed significant decreases in neuromuscular performance and muscle mass during detraining, while post detraining muscle sum value was only in ECC significantly higher than at pre training